Complete this form at least five (5) days before the employees last day in the office and fax it to the Help Desk at    202-687-1162. The process may require the Help Desk to get in contact with the department with follow up questions or other issues.

Name ____________________________________________  NetID __________________

Job title ___________________________________________________________________

Date of last workday in the office __________________________________________

Accounts the employee owned (please check all that apply)

      _____ NetID password                                                                    _____ CFDev

      _____ GUMail account (includes deleting mail in the account)     _____ Epsilon

       _____ @georgetown.edu routing                                                  _____ Genesys

       _____ GUShare                                                                               _____ SIS

       _____ Voicemail, extension _______                                          _____ PeopleSoft Financials

       _____ GUCalendar Resources  _______________                    _____ PeopleSoft Admissions

       _____ GUCalendar Event Calendar  _______________              _____ Peregrine

       _____ GUSUN for web space                                                           _____ Cognos

       _____ Admin NetIDs/Aliases owned by departing employee (please list) _________________

       _____ Other Accounts _____________________________________ 

Departmental contact in case of questions _____________________________________
(please include name AND phone number)

Department Head __________________________________________________

Department Head Signature ______________________________  Date _____________